Sample Record
Owner Lab
- CT D02 - North Region Materials Lab
DIME Sample ID 2020-05-26-22
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214516 DEA: 024H2404 EFIS: 0218000098 |
|---|---|
| DIST-CO-RTE-PM | 02-TRI-3-32.0/38.0,53.7/63.8 |
| Award Date | 12/23/2019 |
| Closeout Date | 02/18/2021 |
| Work Description | PLACE HMA (TYPE A) OVERLAY, SHOULDER BACKING, AND TRAFFIC STRIPE. |
| Location Description | TRINITY COUNTY NEAR WEAVERVILLE FROM 0.4 MILE NORTH OF BROWNS RANCH ROAD TO 0.1 MILE NORTH OF RUSH CREEK ROAD AND FROM EAST FORK STUART BRIDGE TO 2.4 MILES NORTH OF EL DORADO WAY |
| QA Service Level | 1 (Verified on 01/22/2020) |
Sample Information
| Sample Taken Date | 05/26/2020 | Sample Unique Key | 22 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 05/26/2020 |
| Sample type | Verification | A brief description of the sample | 3/8" Type A HMA PG 64-28 M |
| The quantity of what the sample constitutes | not provided | From where was the sample collected | Source |
| First name of sampler or witnessed by | DXXX | Last name of sampler or witnessed by | Norper |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | D78447 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Tullis Northstate Asphalt | Transportation Laboratory (TL) Number | 002551 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
|---|---|---|---|
| HMA Grading | 3/8 inch | Lot number | |
| Sublot number | JMF Verification ID |